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Individual

DR. HUNDAOL SHAMSAN YADETA

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
2131 O ST NW, WASHINGTON, DC 20037-1008
(609) 585-1122
Mailing address
PO BOX 7411009, CHICAGO, IL 60674-3009

Taxonomy

Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
33306
WV
207R00000X
Internal Medicine Physician
Primary
35.148408
OH
207R00000X
Internal Medicine Physician
Primary
MD600005574
DC

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
1598384307
WV
Enumeration date
04/11/2020
Last updated
04/13/2026
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